42 C.F.R. § 456.609

The team must determine in its inspection whether—

(a) The services available in the facility are adequate to—

(1) Meet the health needs of each beneficiary, and the rehabilitative and social needs of each beneficiary in an ICF; and

(2) Promote his maximum physical, mental, and psychosocial functioning.

(b) It is necessary and desirable for the beneficiary to remain in the facility;

(c) It is feasible to meet the beneficiary's health needs and, in an ICF, the beneficiary's rehabilitative needs, through alternative institutional or noninstitutional services; and

(d) Each beneficiary under age 21 in a psychiatric facility and each beneficiary in an institution for Individuals with Intellectual Disabilities or persons with related conditions is receiving active treatment as defined in § 441.154 of this subchapter.